Traumatic Experiences, Psychological Distress and Suicide-Related Behaviors in Autistic Adults

Autistic adults have increased risks of trauma, suicide, and poor mental health compared to non-autistic adults, with 1 in 4 autistic adults attempting suicide. We administered an anonymized, self-report survey to 424 autistic and 345 non-autistic adults through a convenience sampling framework. Binomial logistic regression models identified whether trauma and autism diagnosis were related to (i) self-harm, (ii) suicide attempts, (iii) suicide plans, (iv) a mental health condition that impacts daily life, and (v) substance use to cope. Heatmaps were generated to identify traumas that frequently co-occur with psychological distress and SRB. After accounting for trauma and demographic differences, autism remained a significant predictor of all outcomes, except whether individuals used substances to cope (OR: 0.78, 95% CI: 0.54-1.12, p = 0.18). Autistic people were more likely to report self-harm (OR: 2.71, 95% CI: 1.85-4.00, p < 0.01), suicide attempts (OR: 2.45, 95% CI: 1.65-3.68, p < 0.01), suicide plans (OR: 2.00, 95% CI: 1.41-2.83, p < 0.01), and experiencing a mental health condition that impacts daily life (OR: 3.58, 95% CI: 2.42-5.33, p < 0.01) than non-autistic people. Among autistic people, childhood victimization co-occurred with a mental health condition that impacts daily life, self-harm, and suicide plans most frequently. This study provides evidence of complex relationships between autism, trauma, self-harm, suicide attempts, suicide plans, and a mental health condition that impacts daily life. Focusing on the prevention of trauma, coping strategies, and recovery from traumatic events through safeguarding and support may be critical tools for suicide prevention among autistic people.